Individual
MICHELINE MESIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1201 PENNSYLVANIA AVENUE 15 H, BROOKLYN, NY 11239
(347) 410-3248
Mailing address
1201 PENNSYLVANIA AVE APT 15H, BROOKLYN, NY 11239-1212
(347) 410-3248
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1409422
NY
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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